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Job Summary

Beacon Hill's client is looking for a Prior Authorization Specialist who will serve as a central contact for patients, providers and payers, via telephone (and potentially in person), assisting them in obtaining insurance pre-authorization for procedure. This individual will provide exceptional customer service to meet the needs of patients and other healthcare providers.

This position is onsite in Plymouth, MN and a direct-hire position.

Key Responsibilities

• Operates computer and phone system to appropriately and accurately record contacts, discussions, patient tracking and the pre-authorization process.
• Verifies and updates patients' insurance and demographic information.
• Researching and recording payer processes for pre-authorizations and appeals
• Verifies and updates insurance cards/ eligibility, other billing-related documents and
• completes work activities to ensure work assigned is completed in a timely manner.
• Follows regulatory and organizational processes to ensure the necessary forms are completed
• Operates a fax machine, photocopier and/or printer effectively to communicate patient
• Information to the necessary recipients.
• Identifies and resolves problems in a professional and timely manner by collecting and
• relaying information to appropriate team to ensure resolution.
• Pleasant demeaner with patients and their providers
• Regular in-office attendance is required to carry out the essential functions of the position.
• Reviews and meets ongoing competency requirements of the role to maintain the skills,
• knowledge, and abilities to perform, within scope, role specific functions.

Qualifications and Skills

• High School Diploma or GED.
• 1 year of physician billing
• Patient insurance verification or pre-authorization experience in a health care setting, required; 2 years preferred
• Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors required
• Basic understanding of medical terminology
• HIPAA regulations and Microsoft Office programs

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